Impact of chronic endometritis treatment in patients with reproductive failure

To assess whether the diagnosis and antibiotic treatment of chronic endometritis improve reproductive outcomes in patients with recurrent pregnancy loss or recurrent implantation failure.

This retrospective study included 67 women with recurrent pregnancy loss or recurrent implantation failure. Chronic endometritis was diagnosed in 30 patients (44.8%) based on hysteroscopic findings, CD138-positive histology, or a positive endometrial culture. All patients diagnosed with chronic endometritis received first-line antibiotic therapy, most commonly doxycycline 200 mg/day for 14 days.

Following antibiotic therapy, 17 patients (56.7%) achieved a clinical pregnancy and 12 (40%) achieved a live birth. Clinical pregnancy and live birth rates were similar in women with recurrent pregnancy loss (60% and 40%, respectively) and those with recurrent implantation failure (55% and 40%, respectively), with no statistically significant differences between patients with resolved and persistent chronic endometritis (p>0.05).

In this study, antibiotic treatment for chronic endometritis was not associated with a statistically significant improvement in reproductive outcomes. The heterogeneity of diagnostic and therapeutic approaches highlights the need for standardized criteria and well-designed prospective studies to clarify its clinical relevance.